LONG-TERM SURVIVAL OF PATIENTS WITH OBSTRUCTIVE SLEEP-APNEA TREATED BY UVULOPALATOPHARYNGOPLASTY OR NASAL CPAP

Patients with obstructive sleep apnea (OSA) have decreased long-term s urvival. Treatment of OSA with either nasal continuous positive airway pressure (CPAP) or tracheostomy improves survival, but the effect of uvulopalatopharyngoplasty (UPPP) on survival is unclear. We attempted to contact all patients with OSA treated with either UPPP or nasal CPA P over a 6-year period to compare long-term survival between these two treatments. One hundred fifty-four patients had a UPPP during this pe riod. Five of these patients were later treated with nasal CPAP and we re excluded from the analysis. Twelve of the remaining 149 were unavai lable for follow-up but were included in the analysis. Follow-up polys omnography was performed on 140 (94 percent) of these patients; 114 (8 1 percent) had either a postoperative apnea index < 5/h or > 50 percen t reduction in apnea index. Two hundred eight patients were started on a regimen of nasal CPAP during the same period. Eighty-two patients d iscontinued nasal CPAP therapy and were excluded from analysis. Nine o f the remaining 126 were unavailable for follow-up but were included i n the analysis. Six patients treated with UPPP died. Three of these si x patients had a 3-month follow-up polysomnogram that revealed apnea i ndices of 1/h, 5/h, and 23/h. Three patients treated with nasal CPAP d ied. There was no difference in the long-term survival between the two treatment groups. We conclude that there may be no difference in the long-term survival of patients with OSA between those treated with UPP P and those treated with nasal CPAP. This study emphasizes the importa nce of follow-up polysomnography in all patients after UPPP.